Shawnee Health Service And Development Corp in Carterville - Adolescent Medicine
Shawnee Health Service And Development Corp - NPI 1639295314
Shawnee Health Service And Development Corp is a Adolescent Medicine in Carterville, Illinois. Shawnee Health Service And Development Corp practices all healthcare services and medical treatments related to Adolescent Medicine. The NPI Number for Shawnee Health Service And Development Corp is 1639295314. The last update date is 2018-12-19.
Shawnee Health Service And Development Corp's current location address is 109 California St, Carterville, Illinois. You can contact this provider via phone number 6189858221 and fax number 6189856860. The mailing address for Shawnee Health Service And Development Corp is 109 California St, Carterville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Shawnee Health Service And Development Corp |
|---|---|
| Address | 109 California St, Carterville, Illinois |
| Phone Number | 6189858221 |
| Fax Number | 6189856860 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Jensen Patsy |
| Telephone Number | 6189569508 |
NPI Number Detail
| NPI Number | 1639295314 |
|---|---|
| Provider Enumeration Date | 2007-03-22 |
| Last Updated Date | 2018-12-19 |
Provider Mailing Address Detail
| Address | 109 California St |
|---|---|
| City | Carterville |
| State | Illinois (IL) |
| Post Code | 629180577 |
| Phone Number | 6189858221 |
| Fax Number | 6189856860 |
Provider's Primary Taxonomy Detail
| Speciality | Adolescent Medicine |
|---|---|
| Taxonomy | 207Qa0000X |
|
Definition: A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 24 | IL | -- | |
| 10032052 | IL | BLUE CROSS BLUE SHIELD | |
| 640701 | MEDICARE PART B GROUP ID | ||
| CF3444 | IL | MEDICARE RAILROAD | |
| 20 | IL | -- | |
| 13 | IL | -- | |
| 18 | IL | -- | |
| 19 | IL | -- | |
| 22 | IL | -- |
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What is the unique 10-digit identification code issued to Shawnee Health Service And Development Corp by the Centers for Medicare & Medicaid Services?
The Shawnee Health Service And Development Corp has been assigned the NPI (National Provider Identifier) 1639295314 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Shawnee Health Service And Development Corp located?
The Shawnee Health Service And Development Corp is located at 109 California St, Carterville, IL 629180577.
What is Shawnee Health Service And Development Corp's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Shawnee Health Service And Development Corp is Adolescent Medicine, and the taxonomy code that categorizes this field of expertise is 207Qa0000X.
When did Shawnee Health Service And Development Corp receive its 1639295314 assignment?
The Shawnee Health Service And Development Corp was assigned its 1639295314 on 2007-03-22, which is the date when this unique identifier was issued to the organization.
When was the Shawnee Health Service And Development Corp's information last updated?
The Shawnee Health Service And Development Corp's information was last updated on 2018-12-19.